Impact of Severe Weather on Operations of a Radiation Oncology Department

Abstract

In 2022, two major storms in Western New York brought blizzard conditions and historic snowfall amounts to the region. Beyond the immediate impact to life and property, these weather events resulted in disruptions to cancer care as a result of hazardous travel conditions, and facility closures as a result of regional travel bans. We sought to understand the impact of these disruptive incidents on departmental operations to develop better contingency plans for future occurrences. The radiation treatment machine schedules for a large academic center in Western New York, as well as a neighboring affiliated satellite clinic were queried for daily treatment adherence rates from November 1, 2022 through February 4, 2023. We classified "severe weather days" based on travel advisories issued by the National Weather Service or from local county officials. Out of a total of 68 working days during the study period, 15 days were classified as having severe weather. We compared the percentage of scheduled patients treated (adherence rates) on severe weather days compared with days without severe weather. Statistical analysis was performed using a two-tailed Z-test for proportions. Under routine operating conditions, out of a total of 7045 scheduled treatment visits, we found a mean daily treatment adherence rate of 93.57%. On severe weather days, out of a total of 2093 scheduled treatments, we found a mean daily treatment adherence rate of 77.83%. Out of these 15 days, the satellite clinic closed for a total of 3 days, while the academic center closed for 1 day. Excluding the dates of facility closure, overall treatment adherence rate was 84.76% on severe weather days (Risk Ratio: 0.91). We found that the difference in treatment adherence rates between regular and severe weather days was statistically significant (p<0.001), even when excluding dates of facility closure. This study demonstrates a significant reduction in treatment adherence rates around severe winter storms, even when excluding dates of facility closure. We suggest that preparation for such incidents be a part of facility contingency planning. Weekend openings can be considered for closures ≥ 2 days, or sustained adherence rates of 85% or less for 3 or more days.